What are the most common causes of clavicle fractures. How can you identify a broken collarbone. What treatment options are available for clavicle fractures. Why are clavicle fractures more common in young men. How long does it take for a clavicle fracture to heal. Can ultrasound therapy accelerate clavicle fracture healing.

Understanding the Anatomy and Function of the Clavicle

The clavicle, commonly known as the collarbone, plays a crucial role in our upper body’s structure and function. These S-shaped bones span across the chest, connecting our arms to the trunk of our body. Unlike other long bones, clavicles are unique in their horizontal orientation.

Each person has two clavicles, one on the left and one on the right, positioned just above the first rib. These bones are integral in forming the shoulder and enabling a wide range of arm movements. Interestingly, clavicles continue to grow from before birth until our mid-twenties, making them slow-growing bones.

Evolutionary Perspective on Clavicles

From an evolutionary standpoint, clavicles are not universal among animals. They are primarily found in mammals with prehensile hands and feet, such as primates and raccoons, as well as in bats. Birds have a similar structure, but their clavicles are fused into what we know as the wishbone.

The Prevalence of Clavicle Fractures

Clavicle fractures are remarkably common, accounting for approximately 5% of all adult fractures. In Canada alone, an estimated 12,600 people suffer from a broken collarbone each year, making it the most frequently occurring fracture.

Why are clavicle fractures so prevalent? The answer lies in the bone’s position and function. The clavicle is exposed and lacks the muscular protection that other bones enjoy. Additionally, its role in transferring force from the arm to the body makes it susceptible to breakage during falls or impacts.

Demographics of Clavicle Fractures

• Young adults under 30 are more likely to experience clavicle fractures
• Males are more than twice as likely to fracture a clavicle compared to females (68% vs. 32%)
• Children may sustain fractures from playground accidents or falls from bed
• Elderly individuals are at risk due to increased fall susceptibility
• There may be a seasonal correlation, with more fractures occurring in summer

Common Causes and Mechanisms of Clavicle Fractures

Clavicle fractures typically result from significant force applied to the shoulder area. The most common scenarios leading to these fractures include:

1. Falling horizontally onto the shoulder
2. Landing on an outstretched hand
3. High-energy impacts from car accidents
4. Sports-related injuries

These situations create enough pressure to cause the bone to snap or break, often at its midsection where it’s most vulnerable.

Recognizing the Signs and Symptoms of a Clavicle Fracture

Identifying a clavicle fracture is crucial for prompt treatment. The signs and symptoms are often quite noticeable due to the significant pain associated with the injury.

Key Indicators of a Clavicle Fracture

• Limited and painful movement in the arm or shoulder on the affected side
• Pain, swelling, and tenderness over the collarbone area
• A visible bulge or tenting of the skin where the fracture occurred
• Inability to lift the arm due to pain
• A grinding or crackling sound when attempting to raise the arm

Can you diagnose a clavicle fracture at home? While these symptoms strongly suggest a fracture, a proper diagnosis requires medical imaging. X-rays are typically used to confirm the fracture and assess its severity. In more complex cases, MRI or CT scans may be necessary. For children, ultrasound can be an effective diagnostic tool.

Treatment Options for Clavicle Fractures

The treatment approach for clavicle fractures depends on the severity and location of the break. In many cases, non-surgical methods can effectively heal the fracture.

Non-Surgical Treatment

For simple fractures, the following conservative treatments are often sufficient:

• Arm support (such as a sling) to immobilize the area
• Ice application to reduce swelling and pain
• Pain medication to manage discomfort
• Physical therapy to maintain and restore range of motion
• Time and rest to allow natural healing

Surgical Intervention

When is surgery necessary for a clavicle fracture? Surgery may be required in cases of severe fractures or when the bone doesn’t heal properly after 3-6 months of conservative treatment. Surgical procedures typically involve:

• Realigning bone fragments
• Fixing the fragments in place using plates, pins, or screws
• Ensuring proper positioning for optimal healing

The goal of both surgical and non-surgical treatments is to restore full range of motion in the affected arm without pain.

The Healing Process and Recovery Timeline

How long does it take for a clavicle fracture to heal? The healing time for clavicle fractures can vary significantly based on several factors:

• Age of the patient
• Overall health and nutritional status
• Complexity of the fracture
• Location of the break

On average, clavicle fractures can take several months to heal completely. The thick periosteum (outer layer of the bone) often remains intact during a fracture, which aids in holding the bone together and facilitating healing.

Stages of Clavicle Fracture Healing

1. Inflammation (first few days): The body’s initial response to injury
2. Soft callus formation (2-3 weeks): Development of new bone tissue
3. Hard callus formation (3-4 months): Solidification of new bone
4. Bone remodeling (several months to a year): Reshaping and strengthening of healed bone

Innovative Treatments: Ultrasound Therapy for Clavicle Fractures

Recent studies have shown promising results in using ultrasound therapy to accelerate the healing of clavicle fractures. This non-invasive treatment option has gained attention for its potential to reduce healing time and improve outcomes.

Effectiveness of Ultrasound Therapy

How effective is ultrasound therapy in treating clavicle fractures? Research indicates significant success rates:

• 91% success rate for delayed unions (fractures taking longer than usual to heal)
• 86% success rate for nonunions (fractures that don’t heal on their own)

These findings suggest that ultrasound therapy could be a valuable adjunct to traditional treatment methods, potentially reducing the need for surgical intervention in some cases.

Preventing Clavicle Fractures: Tips and Strategies

While not all clavicle fractures can be prevented, certain precautions can help reduce the risk:

• Wear appropriate protective gear during sports and high-risk activities
• Practice proper falling techniques in sports like cycling and skateboarding
• Maintain good bone health through diet and exercise
• Create a safe home environment to prevent falls, especially for children and the elderly
• Use seatbelts and proper restraints in vehicles to minimize injury risk in accidents

By understanding the causes and mechanisms of clavicle fractures, individuals can take proactive steps to protect themselves and their loved ones from this common injury.

Long-Term Outlook and Potential Complications

What is the long-term prognosis for individuals who have suffered a clavicle fracture? In most cases, with proper treatment and care, patients can expect a full recovery and return to normal activities. However, it’s important to be aware of potential complications:

Possible Complications

• Malunion: Improper healing leading to deformity
• Nonunion: Failure of the bone to heal completely
• Shoulder stiffness or reduced range of motion
• Chronic pain or discomfort
• Nerve or blood vessel damage (rare)

Regular follow-up appointments and adherence to rehabilitation protocols can help minimize these risks and ensure optimal recovery.

Return to Activities

The timeline for returning to normal activities varies depending on the severity of the fracture and the individual’s healing progress. Generally, patients can expect:

• Gradual return to light activities within 6-8 weeks
• Return to non-contact sports around 3-4 months post-injury
• Full return to contact sports or high-impact activities after 4-6 months, with physician approval

It’s crucial to follow medical advice and not rush the recovery process to prevent re-injury or complications.

Clavicle Fractures in Special Populations

While clavicle fractures can affect anyone, certain populations require special considerations in terms of treatment and recovery.

Pediatric Clavicle Fractures

How do clavicle fractures in children differ from those in adults? Children’s bones have a remarkable ability to heal quickly and remodel, often resulting in better outcomes. Key points include:

• Faster healing times compared to adults
• Greater potential for bone remodeling
• Less frequent need for surgical intervention
• Importance of monitoring growth and development post-fracture

Clavicle Fractures in Athletes

For athletes, clavicle fractures can be particularly challenging due to the desire for a quick return to sport. Considerations for this group include:

• Potential need for more aggressive treatment to expedite return to play
• Importance of sport-specific rehabilitation
• Psychological aspects of injury and recovery
• Strategies for preventing re-injury upon return to sport

Geriatric Clavicle Fractures

Elderly patients with clavicle fractures face unique challenges:

• Increased risk of complications due to osteoporosis
• Longer healing times
• Greater impact on overall mobility and independence
• Need for careful pain management and fall prevention strategies

Tailored treatment plans that consider these factors are essential for optimal outcomes in each of these populations.

Advancements in Clavicle Fracture Treatment

The field of orthopedics continues to evolve, bringing new approaches to treating clavicle fractures. Recent advancements include:

Minimally Invasive Surgical Techniques

How have surgical treatments for clavicle fractures improved? New minimally invasive procedures offer several benefits:

• Smaller incisions leading to less scarring
• Reduced risk of infection
• Faster recovery times
• Improved cosmetic outcomes

3D Printing in Orthopedics

The use of 3D printing technology is revolutionizing orthopedic treatments, including those for clavicle fractures:

• Custom-designed implants for complex fractures
• Preoperative planning using 3D models
• Potential for improved fit and function of surgical hardware

Biological Augmentation

Emerging biological treatments aim to enhance the body’s natural healing processes:

• Use of growth factors to stimulate bone formation
• Stem cell therapies to promote tissue regeneration
• Platelet-rich plasma injections to accelerate healing

These advancements offer promising options for improving outcomes and reducing recovery times for patients with clavicle fractures.

Living with a Clavicle Fracture: Practical Tips and Lifestyle Adjustments

Recovering from a clavicle fracture requires patience and adaptation. Here are some practical tips for managing daily life during recovery:

Daily Activities and Self-Care

• Use button-up shirts or loose-fitting clothing to ease dressing
• Consider using a shower chair to prevent falls and make bathing easier
• Use pillows for support while sleeping to maintain a comfortable position
• Prepare meals that require minimal preparation or seek assistance with cooking

Pain Management Strategies

How can you effectively manage pain from a clavicle fracture? Consider these approaches:

• Follow prescribed pain medication regimens carefully
• Use ice therapy to reduce swelling and discomfort
• Practice gentle range-of-motion exercises as directed by your healthcare provider
• Explore relaxation techniques like deep breathing or meditation to cope with pain

Maintaining Physical and Mental Well-being

Staying active and positive during recovery is crucial:

• Engage in approved low-impact exercises to maintain overall fitness
• Practice mindfulness or seek counseling to manage emotional challenges
• Stay connected with friends and family for social support
• Set realistic recovery goals and celebrate small milestones

By implementing these strategies, patients can navigate the recovery process more comfortably and maintain a positive outlook throughout their healing journey.

Clavicle Fractures – Fracture Healing

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Clavicle Fractures

Break a bone? It’s likely a clavicle. Here’s why collarbone fractures are the most common.

Throwing the perfect pitch. Hitting a tennis ball. Reaching something high off a shelf. These activities all include the use of your collarbones, which help form the shoulder and allow for a range of motion in your arms. But a collarbone break is the fracture most likely to happen to you, accounting for five percent of all adult fractures. And young men are the ones who break their collarbones the most often.

The collarbone’s connected to the arm bone

The clavicles, also called collarbones, span across the chest and connect your arms to the trunk of your body. They are curved, S-shape bones and the only long bones in our body that lie horizontally. We all have two collarbones — one on the left and one on the right, situated directly above the first rib. They form the shoulder and allow the arm to have a maximum range of movement.

Clavicles are slow-growing — they continue to grow from before we were born to our mid-twenties.

The only other animals that have collarbones are mammals with prehensile hands and feet, such as primates and raccoons, and bats. In birds, the clavicles are fused together into the wishbone.

A collarbone break is the most common fracture, especially among young men

Approximately 12,600 people break a collarbone in Canada every year, making it the most common fracture sustained. Fractures happen because of injury or trauma to a clavicle, especially at the midsection of the bone, and can be very painful.

The most common way to break a collarbone is to fall horizontally on your shoulder or on an outstretched hand. This creates enough pressure that the bone snaps or breaks.

Everyone can break a clavicle, but it is more likely to happen to young men. People under 30 years old are more likely to break a collarbone usually resulting from a high energy impact, such as in a car accident or sports injury. Males are more than twice as likely to fracture a clavicle as females, at a rate of 68% to 32%.

Young children may sustain a collarbone fracture from falling off playground equipment or out of bed. Elderly people may sustain a fracture from a fall. There may even be a seasonal correlation, with more clavicle fractures occurring in the summer.

How do I know if I’ve broken a collarbone?

Clavicle fractures happen after a great amount of force is applied to the shoulder. The break can be very painful, so it may be obvious that something has broken.

Signs and symptoms of a clavicle break:

• Limited, painful movement in arm or shoulder on side of the fracture
• Pain, swelling, and tenderness over the collarbone
• Bulge or tenting of the skin on collarbone where fracture happened

Healing the break and returning back to regular activities

Clavicle breaks are usually diagnosed with an X-ray; more severe fractures may require an MRI or CT scan. An ultrasound can be used to diagnose clavicle fractures in children. The X-ray shows the physician where the fracture occurred and the severity of the injury to the bone.

Some clavicle fractures can cause the bone to just crack or to break into pieces. The most common fractures are at the middle of the collarbone between the breastbone and the shoulder joint or near the shoulder joint. The least common break is towards the center of the body, near the breastbone. During some injuries, pieces of the bone can be moved out of place and surgery may be needed to realign the collarbone.

Healing of bones can take several months and the healing time varies based on age, health, complexity, and location of the break. Clavicles have thick periosteum, the outer layer of the bone, which doesn’t usually break and holds the bone together while it heals. Some clavicle breaks will heal with arm support (like a sling), ice, pain medicine, physical therapy, and time.

Severe breaks or bones that don’t heal themselves after three to six months may require surgery. Surgery is used to put the bone pieces back together and in the correct locations, and then preventing them from moving out of place until healed. Plates, pins, or screws may be used to properly position the clavicles. The end goal is to have a full range of motion in the arm on the affected side, without feeling any pain.

Using ultrasound therapy to heal clavicle fractures

Studies have found that ultrasound therapy can accelerate healing. A delayed union is a fracture that takes longer than usual to heal but is expected to heal on its own without surgery. A nonunion is a broken bone that doesn’t heal on its own and may require surgery. (A healed bone is also called a “united” bone.) A study found that the overall success rate of healing fractures with ultrasound treatment for delayed unions was 91% and for nonunions 86%.

Low-Intensity Pulsed Ultrasound (LIPUS) is an ultrasound treatment that helps bone fractures heal faster. When placed against the skin at the fracture, a painless mechanical force is used to stimulate the bone through the tissue. LIPUS devices can advance healing in just twenty minutes a day — that’s shorter than most sitcoms — and are used at home without medical supervision.

Ultrasound fracture healing devices are available directly to patients and clinics through Medlines Inc., which distributes LIPUS devices in Canada with a subsidized rental program for patients without insurance. One-on-one training and help with insurance coverage are also provided. Medlines Inc. has more than 15 years of experience in the medical device field, specifically helping patients to recover from fractures and get back to your regular life activities sooner.

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Clavicle Fractures | ShoulderDoc

The clavicle (collarbone) is the prominent bone on either side at the front of your shoulders and top of chest (see Anatomy ). The clavicle is the only bony link between the shoulder and the body itself, as well as providing protection to important underlying blood vessels and nerves.

Clavicle fractures make up 5% of all fractures, so are not uncommon. It is a common injury in contact sports (rugby, martial arts) and impact sports (such as horse and motor racing).

Clavicle fracture fixed with reconstruction plate and screws:

Treatment: 

Most clavicle fractures are mainly treated in a sling for about 4-6 weeks. Clavicle braces may provide more comfort if applied correctly and align some fractures in a more stable position.
However complete healing can be slow and may take up to 3-6 months. After 6 months about 15% of clavicle fractures still may have not healed. This is known as a “nonunion”.

Early fixation of clavicle fractures has some advantages, such as:

• Earlier return to work and activities
• Less pain (a the fracture is stabilised)
• Better chance of healing (as the bone ends are lined up together)
• Less chance of deformity (mal-union)

However, there are potential complications, which include:

• risk of infection
• risk of numb patch below scar
• possible scar problems (which could be cosmetically unattractive)
• failure of fixation

Therefore, the decision to perform surgery is not undertaken lightly. A surgeon may be more likely to offer early surgery in the following circumstances:

• multiple fractures
• associated scapula fracture ( floating shoulder )
• open (compound) fracture
• associated nerve or blood vessel injury
• very displaced fracture (tenting the skin)
• overlap of the fracture ends causing shortening of the clavicle
• high velocity injury with multiple bone fragments (comminuted)
• professional sports person

The standard method of fixation is a rigid plate and screw fixation. New plates are designed specifically for the clavicle and are low profile and very strong. This allows early mobilisation and other advantages over the older systems. Nailing of the clavicle is a technique suitable for more simple, less displaced and lower velocity clavicle fractures. It is particularly suitable for growing children and adolescents. A second operation is required to remove the nail.  

I like to use the non-union prediction calculator , developed by Robinson et al. to assist in my decision making. This information is helpful to patients when discussing the pros and cons of the treatment options.

For more details about the surgery click here

Clavicle Nonunion 

If the clavicle has not healed by 3 months it is called a ‘nonunion’. These are usually painful and require surgical fixation.

The surgery involves fixing the clavicle with a plate and screws, plus adding bone graft to aid the healing.

Clavicle Malunion 

If the clavicle heales in a displaced position, this is called a ‘malunion’. This is accompanied by a step (deformity) in the clavicle.

This can lead to ongoing shoulder problems, especially in athletes and manual workers. Significant shortening of the clavicle can alter the normal alignment of the shoulder girdle leading to dysfunction with high demand activities.

Clavicle malunion on right side

Also see:

• Clavicle Malunion. Chan & Jupiter – JSES. 1999.
• Short malunions of the clavicle: An anatomic and functional study
• Closed treatment of displaced middle-third fractures of the clavicle gives poor results

Also see:

• Latest Research on the Clavicle

X-ray of the clavicle in Rostov-on-Don | The price of a picture is from 700 rubles. Order a service in the center “Best_Clinic”

The clavicle is part of the human musculoskeletal system, therefore it plays an important role in the work of the shoulder girdle. This bone is highly fragile and often suffers from fractures. Injuries also occur when the clavicle has a congenital pathology or an inflammatory process occurs in it. In children, the clavicle breaks while maintaining the integrity of the periosteum. Displaced fractures are common in adults.

X-rays of the clavicle are performed only with a doctor’s order. The picture performs a number of functions: a direct posterior projection is needed to diagnose a fracture. The purpose of the AP X-ray is to reveal the bony structure of the clavicle. An axial view is needed to determine the direction of displacement of the clavicle fragments.

When you need an x-ray

An x-ray of the clavicle is prescribed to monitor bone fusion after a fracture. The traumatologist evaluates how correctly the bone fragment was assembled and how quickly healing takes place. X-rays also help to identify birth defects and anomalies in the structure of the clavicular-acromial joint. If clavicle fractures occur too frequently, then this may be a sign of osteoporosis in the patient. Signs of this disease can also be seen on an x-ray.

A fracture is characterized by a number of symptoms:

1. Disruption of the shoulder girdle. With the help of a picture, the doctor determines whether the collarbone has defects (for example, a congenital bone pathology).

2. Pain in the clavicle, which is accompanied by reddening of the skin, inflammation of the lymph nodes (these may be signs of osteomyelitis).

3. Pain in the shoulder girdle. The cause may be a fracture of the bone, dislocation as a result of trauma, bruise, fall, road traffic accident, fracture of the collarbone. An x-ray will help make an accurate diagnosis.

Contraindications for radiography

It is forbidden to conduct preventive X-ray examinations for pregnant, lactating mothers. The procedure must be postponed to a later date, when lactation is completed.

If a woman of childbearing age is sent for an x-ray, then the radiologist should clarify with her the time of the last menstruation. This is due to the fact that radiation exposure to the gonads (pelvic, gastrointestinal, urinary system) is best done in the first 10 days of the menstrual cycle. It is during this period that the likelihood of pregnancy is minimal. If the pregnancy has not yet been confirmed, then the doctor assumes that there is a pregnancy and transfers the x-ray to another period.

X-rays are not prescribed for patients in serious condition, non-transportable patients.

X-rays are not recommended for children under 14 years of age. At this age, there is an active growth of the body, which can be adversely affected by X-rays – to provoke malignant degeneration of cells.

Preparation for the procedure

An X-ray of the clavicle does not require special preparation. Before taking a picture, you need to free the area under study from clothing to the maximum. Remove jewelry, metal elements of clothing, chains, watches, belts, etc. Remove long hair from the shoulders.

The examination area should be free from dressings, plasters, electrodes and other foreign objects that may reduce the quality of the resulting image. The rest of the body is covered with a protective apron that shields x-rays.

How is the procedure

X-ray of the clavicle is performed in 3 projections – anteroposterior, oblique (tangential) projection, standing.

Stage number 1. First, an anteroposterior projection of the clavicle is performed.

1. The patient is placed with his chest to a vertical stand, the collarbone is located opposite the film (possibly the position “lying on the stomach”).

2. The patient’s face is turned to the opposite side.

3. The hands on the examined side are turned inward (the back of the hand is turned to the counter), the other is located along the body, as usual.

The X-ray beam is directed perpendicular to the film. The central beam shines through the middle of the clavicle and into the center of the film. During the exposure, the patient holds their breath while exhaling for a few seconds.

Stage number 2. Then an oblique projection of the clavicle is performed. The X-ray beam is directed from front to back with a shift at an angle of 450 caudal and perpendicular to the film. The central beam shines through the middle of the clavicle. Hold your breath as you exhale.

There are other options for images of the clavicle:

1. The patient lies on his back (or stands with his back to a vertical stance).

2. The shoulder is slightly raised and fixed so that the clavicle is parallel to the cassette.

3. The arm on the side being examined is turned outward (supination position).

4. The X-ray beam is directed at an angle of 300 caudocranially.

If the image is taken correctly, then the medial and lateral parts of the clavicle are completely visible, without overlays, with the exception of the sternoclavicular joint.

Normal x-rays

An x-ray of the clavicle of a healthy person should have the correct bone shape and size for the age of the patient. There should be no dark places on the bone picture, its contours should be clear, and the bone structure should be dense and uniform.

How often can x-rays be taken

X-rays are performed for medical reasons. The picture is taken no more than 2-3 times a year, under the strict supervision of a doctor.

Traumatologists of the private medical center “Best Clinic” in Rostov-on-Don will quickly and inexpensively make an x-ray of the clavicle in any projection. Contact the clinic directly or call 8(863)200-32-08. For the convenience of patients, appointments are also made online. Send a request in the feedback form.

Rupture of the acromioclavicular joint (ACJ) of the shoulder joint operation |

What is the acromioclavicular articulation of the ACJ.

​

The shoulder joint, together with the scapula, is connected to the rest of the skeleton with the help of one bone – the clavicle.

The clavicle, in turn, is connected to the sternum through the sternoclavicular articulation.

A The scapula is connected to the clavicle through the acromioclavicular joint (ACJ).

Acromioclavicular joint held in place by

clavicular-acromial and clavicular-coracoid ligaments.

How can I get a rupture of the acromioclavicular articulation of the ACJ.

Injury or rupture of the acromioclavicular joint can occur when falling on an outstretched arm during sports activities, rollerblading, skating, snowboarding, or falling on a straight arm in winter during ice.

At the 1st degree of damage, swelling is determined in the area of ​​attachment of the acromial end of the clavicle to the scapula,

at the 2nd degree, we can see the “key syndrome”, the collarbone sinks when pressed and, when released, returns back like a piano key.

At the 3rd degree of ACL rupture, there is a visible deformity, the end of the clavicle protrudes above the scapula for its entire diameter.

How to help yourself with a shoulder injury.

First aid for shoulder joint injury consists in applying cold to the place of greatest pain and immobilizing the upper limb with a scarf bandage.

The diagnosis can be made on the basis of an x-ray.

​

What you need to make a diagnosis in case of damage to the ACL.

X-ray is the most informative examination method for making a diagnosis and determining the degree of damage to the acromioclavicular joint.

A first-degree acromioclavicular rupture will show a separation between the clavicle and the acromion on an x-ray.

In the second degree, we see the protrusion of the clavicle above the acromion at a distance of no more than half its diameter.

In the third degree, the clavicle protrudes above the scapula to its full diameter and even more.

Based on the X-ray, with the third degree of damage, the patient is additionally assigned an MRI – this study will allow us to accurately determine which ligaments were torn, the degree of rupture and will help with the choice of surgical treatment tactics.

​

Treatment of a torn acromioclavicular joint.

​

Tactics for the treatment of ACL rupture is chosen by the doctor based on the degree of damage to the joint and the duration of the injury.

​

As a rule, grades 1 and 2 are treated conservatively.

On the border between the 2nd and 3rd degree of damage and at the 3rd degree, an operation is necessary.

There are several ways of surgical treatment of ACL rupture:

– open surgery, performed through an incision in the tissues of the shoulder joint.

– arthroscopic, the most modern, low-traumatic operation on the ACL.

Open surgery on the acromioclavicular joint.

During an open operation, an incision is made in the clavicle region, while the deltoid muscle is separated (anatomically separated without cutting, but by cleaning) from the clavicle, torn ligaments are exposed, a thin synthetic tape is inserted into the base of the coracoid process, or around it, which presses the collarbone to coracoid process, thereby providing healing of the ligaments (conical and trapezius).

Arthroscopy of the acromioclavicular articulation in acute,

up to 2 weeks from the moment of injury, the degree of damage.

Having performed arthroscopic approaches under the deltoid muscle and under the acromion, we visualize the torn ligaments. A hole is made at the base of the coracoid process, into which we pass a special synthetic 2 mm Fiber Tape and a titanium Endo Button, which is wedged under the coracoid process. Then, between the conical and trapezius ligaments, through the clavicle, without damaging the fibers of the deltoid muscle and ligaments, a second hole is made, into which the same tape is passed and then it is fixed on the clavicle using the second Endo Button reconstructive fixator.

Arthroscopy of the acromioclavicular joint in subacute,

up to 3 months from the moment of injury, degree of damage.

In case of subacute AKC damage, we perform a modified WEAVER-DUNN operation.

In addition to the installed buttons that press the clavicle against the coracoid process, the pre-sutured portion of the coracomial ligament is unfolded and fixed to the clavicle. Thus, non-free plastic surgery of the clavicular-coracoid ligaments is performed using the acromioclavicular ligament.

The modified WEAVER-DUNN operation is not easy to perform. To carry it out with sufficient visualization, high-level anesthetic support is required, which our clinic is equipped with.

Arthroscopy of the acromioclavicular joint in case of chronic,

more than 3 months from the moment of injury, degree of damage.

At this time, a patient with a rupture of the acromioclavicular joint can be helped by performing ACL tendon plasty. During this operation, in addition to fixation buttons and a synthetic tape, a loop is formed from the patient’s semitendinosus muscle isolated from the popliteal region, which is passed around the coracoid process, fixed in the channels in the clavicle and fixed to the acromial process.

Why can we move the ACL?

The coraco-acromial ligament is a rudimentary formation that has lost its main significance in the process of evolutionary development, often causing impingement syndrome and its movement can be considered rather a boon for the patient.

We use a non-aligned tunneling technique at the anatomical attachment points of the ligaments, allowing us to perform a complex operation in the most elegant way. This method of execution is more difficult for the surgeon, but the most optimal for patient recovery.

Why choose arthroscopy for ACL surgery.

In 30 percent of cases, with an injury to the acromioclavicular joint, there is a rupture of the anterior-superior segment of the articular labrum of the shoulder joint – SLAP. That is, for every third patient, performing an operation to suture the ACL arthroscopically, we, using the same accesses, can additionally perform an arthroscopic suture of the articular lip. If in an acute condition damage to the articular lip can be refixed in the anatomical position, then in advanced cases, tenodesis of the tendon of the long head of the biceps is performed, which is somewhat non-physiological.

Timely arthroscopic treatment aimed at eliminating instability in the acromioclavicular joint ensures fusion of not only the ligaments, but also the intraarticular disc. The shoulder joint begins to function physiologically, thereby preventing the development of arthrosis of the ACL, the development of impingement syndrome of the shoulder and, as a result, such a formidable condition as a rupture of the rotator cuff of the shoulder.

Postoperative period during surgery on the acromioclavicular joint.

ACL ligaments fuse 3-4 weeks after the operation.

During this time, the patient is recommended to be immobilized in a soft abduction splint with neutral rotation.

At 3-4 weeks, a rehabilitation program is prescribed, upon successful completion of which and after 4 months after the operation, any sports activities are possible without any restrictions.

Important! During the operation on the acromioclavicular joint, we do not use a hook-shaped plate. Why?

Treatment of an ACL rupture with a hook plate is considered a throwback.

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– The hook-shaped plate must be removed after a while, and this is a second operation.